Prevalence of pneumonia due to Legionella pneumophila and Mycoplasma pneumoniae in a population admitted to a department of internal medicine.

We studied 177 patients with pneumonia admitted to an internal medicine department over a period of 3 years to determine the incidence of two emerging pathogens, Legionella pneumophila and Mycoplasma pneumoniae. Clinical, radiological and laboratory tests were performed and included blood cultures, serology, gram staining and sputum cultures. L. pneumophila was the agent involved in 9 patients (5.1%) and M. pneumoniae in 12 (6.8%). These prevalences were about in the middle of the range of previously published figures. Legionella pneumonia is a rare illness, which even in the absence of suggestive clinical signs must be considered because of its possibly serious course and to allow appropriate therapeutic decisions to be made.

[Comparison between a diet with mainly vegetal protein content and a diet with mainly animal protein content in hepatic cirrhosis]. / Confronto tra una dieta a prevalente contenuto proteico vegetale ed una a prevalente contenuto proteico animale nella cirrosi epatica.

Eight cirrhotic patients were studied in a randomized crossover single blind study in order to compare the effects of two isocaloric, and with equal amount of protein diets on nitrogen balance and on the portal systemic index. One diet was 2:3 vegetable protein to total protein content (diet V) and the other 2:3 animal protein to total protein content (diet A). Each diet was changed every three weeks. Five patients followed the VAV scheme and three the AVA scheme. The mean values of the porto systemic index were almost the same with the two diets while the value of the nitrogen balance was less negative with the diet A than with the diet V, showing an increasing trend, more marked with the diet A, at every consecutive time of observation. The variance analysis was not significant for any of the two diets. Diet V was well tolerated.

Trichinella spiralis as a modulator of Shope fibroma virus.

After the works on the promoting effect of trichinellosis on some viral infections in rodents, many studies successively demonstrated that Trichinella spiralis confers resistance to many unrelated antigens including pathogens, such as Protozoa, Bacteria and tumour cells (B16 melanoma). Considering the above contradictory results, the present work was undertaken to study, in rabbits, T. spiralis as a modulator of Shope's fibroma virus, an oncogenic virus responsible for a benign neoplasia. Four groups of 6 rabbits each were used. The rabbits of group I, II and III were inoculated per os with 3000; 6000 and 12,000 T. spiralis larvae, respectively. The rabbits of group IV were used as controls. Thirty-five days after the inoculation, all the animals were injected at the fixed doses of 0.5 ml with dilutions (10(-1) to 10(-8] of Shope's fibroma virus given intradermally into 8 different points of the skin of each pretreated and untreated rabbits. After 9 days tumour lesions affecting the inoculating area were noticed and the DI 50/0.5 of Shope's fibroma virus was then determined for each of the 4 experimental groups. The rabbits pretreated with T. spiralis exhibited much lower virus titres than the controls, which was evidently related to a certain degree of aspecific immunity conferred by the parasite. The results indicated that T. spiralis produces, in rabbits, resistance to Shope's fibroma virus and its neoplastic effect.

[Hepatocellular carcinoma. Significance of the association with cirrhosis, alcohol consumption and the hepatitis B virus (serum markers and tissue antigens)]. / Carcinoma epatocellulare. Importanza dell'associazione con cirrosi, consumo di alcol e virus epatitico B (marcatori sierici e antigeni tissutali).

In a consecutive series of 35 cases of HCC, 21 (60%) had a habitual alcoholic intake of greater than 80 g/die and 26 (74.2%) were positive for at least one HBV serum marker. At tissue level, HBsAg was positive in non-tumoral tissue in 8 cases (22.9%) and HBcAg in 6 cases (17.1%) in non-neoplastic tissue and in 3 cases (8.6%) in neoplastic tissue with focal type positivity. The positivity of HBsAg presented at cytoplasmatic level and that of HBcAg almost exclusively at nuclear level. The comparatively low expression of HBV antigens at tissue level can be explained by the integration of viral DNA in the host genome which probably took place in many of these cases. Cirrhosis was associated with HCC in 23 cases (65.7%). In 9 (25.7%) cirrhosis was macronodular, in 4 (11.4%) micronodular and in 10 (28.6%) it was mixed. 18 cases (51.4%) presented an association of significant alcoholic consumption and positivity of at least one HBV marker. In 19 cases (54.3%), cirrhosis was associated with positivity of at least one HBV marker. Finally, in 14 cases (40%) there was an association of cirrhosis, alcohol and positivity of at least one HBV marker. These results suggest a multifactorial aetiology of HCC in our geographic area, identifying the factors in question in cirrhosis of the liver, independently of its aetiology (through the hyperplastic-regenerative process that characterises it) in HBV and in alcohol (with direct and independent pathogenetic mechanisms known only in part, or mediated by cirrhosis of which HBV and alcohol represent the two main aetiological agents). In cases in which more than one of the aetiological factors considered was observed, it is legitimate to admit a cocarcinogenic perhaps synergistic hypothesis of this cancer.